Efficacy of topical agents in oral mucositis prevention: Systematic review and network meta‐analysis

• Published in: Oral diseases Vol. 30; no. 7; pp. 4126 - 4144
• Main Authors: Coppini, Martina, Caponio, Vito Carlo Alberto, Mauceri, Rodolfo, Bizzoca, Maria Eleonora, Laino, Luigi, Lorenzo‐Pouso, Alejandro I., Russo, Diana, Troiano, Giuseppe, Silva, Fábio França Vieira E., Lo Muzio, Lorenzo, Campisi, Giuseppina
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.10.2024
• Subjects: Administration, Topical; Anti-Infective Agents - administration & dosage; Anti-Infective Agents - therapeutic use; Antimicrobial agents; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; cancer; Cancer therapies; Clinical trials; Humans; Meta-analysis; Mucositis; Natural products; Neoplasms - complications; Neoplasms - therapy; network meta‐analysis; oral mucosa; oral mucositis; Patients; prevention; Quality of life; Randomized Controlled Trials as Topic; stomatitis; Stomatitis - etiology; Stomatitis - prevention & control; sucralfate; Sucralfate - administration & dosage; Systematic review; therapy; oral mucositis; stomatitis; oral mucosa; therapy; cancer; network meta‐analysis; systematic review; prevention; sucralfate
• ISSN: 1354-523X; 1601-0825; 1601-0825
• DOI: 10.1111/odi.15046

Background Oral mucositis (OM) is considered one of the most common side effects of patients undergoing cancer therapy. OM prevention plays a crucial role in the effectiveness of cancer treatment and the patient's quality of life. Different preventive treatments have been proposed in clinical trials, however with inconclusive results. Materials and Methods A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: in cancer patients, do specific topical agents compared to standard treatments or placebo reduce the onset and severity of oral mucositis? The risk of bias was assessed, and a network meta‐analysis was conducted. Results Of 2913 results, 30 randomized clinical trials were considered suitable for inclusion. A total of 2564 patients were analyzed, of which 1284 belonged to the test group and 1280 belonged to the control group. Natural products were the most used, followed mainly by antimicrobial agents, coating agents, and basic oral care measures. Topical sucralfate resulted in the most powerful intervention for the OM prevention (OR = 0.04, 95%C.I. = 0.01–0.25, p‐value = 0.001). Conclusion Due to its cytoprotective action, low cost, ease of administration, and safety, sucralfate could become a potential ally to prevent the onset of OM during cancer therapy.